2016 год, №4

Содержание выпуска
LOOKING INSIDE MAN: MEDICAL IMAGING
Osipov L.V., Dolgushin M.B., Mikhaylov A.I., Epel B., Rumyantsev K.A., Turoverov K.K., Verkhusha V.V., Kulikova E.Yu.
Стр. 4 — 13
The rapid progress of medical sciences has brought about novel effective medications, new techniques that make surgery less traumatic, artificial materials that serve to replace tissues and organs, and robotic prostheses. Still, treatment success is largely a question of timely and accurate diagnosis and proper patient monitoring. Here, various imaging techniques come in handy. Those are often thought of as tools for anatomy visualization, but in fact, they are often highly effective for the assessment of the functional state of organs and tissues. Imaging techniques are so diverse that it is impossible to cover them all in one review. Therefore, we have decided to touch upon the most common and interesting ones, such as ultrasound imaging, tomography, oximetry and fluorescence imaging.
FLUORESCENCE IMAGING OF ACTIN CYTOSKELETON CHANGES IN CANCER CELLS UPON CHEMOTHERAPY
Klementieva N.V., Furman O.E., Mishin A.S., Lukyanov K.A., Zagaynova E.V.
Стр. 14 — 18
Structural organization of actin and actin-binding proteins can be a hallmark of aggressiveness among various populations of solid tumor cells. Here, we studied the impact of chemotherapeutic drugs (paclitaxel and cisplatin) on actin and alpha-actinin structural patterns in human cervical adenocarcinoma cell culture HeLa Kyoto using total internal reflection fluorescence microscopy and single-molecule localization super-resolution microscopy. It was shown that paclitaxel causes disruption of actin cytoskeleton in cancer cells, both for actin and alpha-actinin. We observed disappearance of stress fibers, accumulation of filaments in the cell cortex and morphological changes in focal contacts. With cisplatin, we detected a lower number of thin actin bundles and more dense arrangement of alpha-actinin. Our results suggest that the actin cytoskeleton is a potential target for antitumor chemotherapy.
MULTIMODAL OPTICAL COHERENCE TOMOGRAPHY IN THE ASSESSMENT OF CANCER TREATMENT EFFICACY
Sirotkina M.A., Kiseleva E.B., Gubarkova E.V., Buyanova N.L., Elagin V.V., Zaitsev V.Yu., Matveev L.A., Matveev A.L.
Стр. 19 — 26
One of the challenges faced by modern medicine is finding new methods of functional imaging of biological tissues in patients that allow detection of early tumor response to treatment. One of such methods proposed in this work is multimodal optical coherence tomography (MM OCT). It combines cross-polarization OCT (CP OCT) for visualization of tissue structure and assessment of connective tissue health, OCT-based microangiography (OCT MA) for visualization of the vasculature, and OCT-based elastography for measuring tissue stiffness. The efficacy of this method was tested during the course of photodynamic therapy (PDT), as major PDT targets are cellular and vascular components of a tumor. The experiments were carried out on the CT26 colon carcinoma transplanted into the mouse ear. It was shown that the efficacy of PDT can be assessed using MM OCT. For example, CP OCT can help differentiate between necrotic and intact tumors; OCT MA detects blood circulation defects that lead to slower blood circulation or circulatory stagnation followed by tumor death. OCT-based elastography is helpful in assessing stiffness of normal and pathological tissues.
DYNAMIC CONTRAST-ENHANCED MRI IN DETERMINING HISTOLOGICAL TYPE OF CERVICAL CANCER
Tarachkova E.V., Shorikov M.A., Panov V.O., Kuznetsov V.V., Tyurin I.E., Shimanovsky N.L.
Стр. 27 — 33
Knowing the histology of cervical cancer (squamos cell carcinoma or adenocarcinoma) is important in deciding on the best treatment plan. We have studied the role of dynamic contrast-enhanced magnetic resonance imaging in the differential diagnosis of cervical cancer. We examined 90 patients between 23 and 78 years of age (mean age was 43.5 years) with histologically distinctive stage llb-IVb cervical cancers. Scanning was performed on Magnetom Espree 1,5T and Magnetom Skyra 3.0T scanners (Siemens, Germany) using gadobutrol (Gadavist by Bayer, Germany). On T1 -weighted images, signal intensity and its rate of change were significantly higher for adenocarcinomas compared to squamos cell carcinomas (p
CONTRAST ENHANCED MRI OF TUMORS USING GADOPENTETIC ACID LINKED TO CYCLODEXTRIN BY AN ESTER BOND
Kulakov V.N., Lipengolts A.A., Grigorieva E.Yu., Semeikin A.V., Abakumov M.A., Karakhanov E.A., Maximov A.B., Shimanovsky N.L.
Стр. 34 — 39
Contrast-enhanced magnetic resonance imaging has become a routine diagnostic procedure. One of the most common contrast agents used for MRI is gadopentetic acid (Gd-DTPA, marketed as Magnevist). In this work, we studied the relaxivity of Gd-DTPA covalently bonded to p-cyclodextrin and compared enhancement properties of this compound and Magnevist. Our work demonstrated high relaxivity of Gd-DTPA complex containing 80 % of Gd-DTPA-modified p-cyclodextrin mono-derivative, 10 % of Gd-DTPA-modified p-cyclodextrin di-derivative and 10 % of Gd-DTPA-modified p-cyclodextrin tri-derivative. Gd-DTPA residues were linked to p-cyclodextrin by an ester bond, in which a COOH group belongs to DTPA and OH is a p-cyclodextrin surface hydroxyl group. It was proved experimentally that the studied compound is not toxic in concentrations necessary for diagnostic procedures. Compared to Magnevist, it can provide similar enhancement when used in just half of the equivalent amount.
NUCLEAR MEDICINE IMAGING IN DEMENTIA
Kondakov A.K., Znamensky I.A., Mosin D.Yu., Grechko A.V.
Стр. 40 — 43
In this work the authors share their opinion on the role of nuclear medicine imaging in the diagnosis and differential diagnosis of dementias. Perfusion single-photon emission computed tomography using Tc-exametazim and F-fluorodeoxyglucose positron emission tomography are highly sensitive and specific; they are recommended for a wide range of clinical applications. The efficacy of amyloid imaging in Alzheimer's is still a matter of discussion, because amyloid accumulation is also typical in patients with other dementias. Dopamine transporter imaging using l-ioflupane is a very reliable diagnostic tool for Parkinson’s disease and Lewy body dementia, and can help to adjust treatment strategies. Further evolution of nuclear medicine methods will most likely include the development of new radionuclide tracers for such targets as microglial cells' activation and neurofibrillary tangles.
POSTMORTEM MAGNETIC RESONANCE IMAGING IN THE DIAGNOSIS OF CONGENITAL PNEUMONIA
Tumanova U.N., Lyapin V.M., Bychenko V.G., Schegolev A.I., Sukhikh G.T.
Стр. 44 — 50
Congenital pneumonia is one of the leading causes of neonatal deaths. In this work we assess the possibility of using postmortem magnetic resonance imaging for the diagnosis of congenital pneumonia. The study was conducted on 21 neonate bodies. Before the autopsy, MRI scanning was performed on the Magnetom Verio 3T system (Siemens, Germany) in T1 and T2 standard modes. The resulting images were used to analyze signal intensities of lung tissue, pleural fluid and air. Airiness index was computed as the ratio of pleural fluid signal intensity to lung tissue signal intensity. Then, the autopsy was performed. Based on the histological analysis results, the main and the control groups were formed. The bodies of 9 neonates who had died from congenital pneumonia were included into the main group; the control group consisted of 12 dead neonates with no signs of pneumonia. On T1 -weighted images, the signal intensity from the lungs of the infants with congenital pneumonia was higher by 26.5 % in the left lung and 12.9 % in the right lung, compared to the controls (p >0.05). On T2-weighted images, the corresponding figures were 23.7 and 31.2 % (p >0.05). The sensitivity of the method is 77.8 %, specificity is 75.0 % and diagnostic efficacy is 76.2 %.
INFLUENCE OF ANESTHETIC TECHNIQUES ON OCCURRENCE OF POSTOPERATIVE COGNITIVE DYSFUNCTION IN ELDERLY PATIENTS UNDERGOING GYNECOLOGICAL SURGERY
Krasenkova E.A., Ovechkin A.Yu., Pyregov A.V.
Стр. 51 — 55
Postoperative cognitive dysfunction (POCD) is a disorder that develops in the early postoperative period, persisting for several days or weeks and leading to decrease in higher cortical functions (speech, memory, attention, etc.). POCD is often associated with anesthetic techniques and drugs. This paper studied the effect of general, neuraxial and combined anesthesia on POCD development in elderly women undergoing gynecological surgery. The study featured 43 patients (mean age 65,0 ± 2.2 years). There were 12 women in the general anesthesia group, 23 in the neuraxial anesthesia group, and 8 women in the combined anesthesia group. Intraoperative monitoring included electrocardiography, non-invasive blood pressure measurement, determination of blood oxygen saturation level (rSO) and determination of bispectral index (BIS monitoring). A day before surgery and on the 5th day after the surgery, neuropsychological tests were carried out through tracking test, Mini-Mental State Examination and frontal assessment battery. All intraoperative indicators were normal in all the patients. POCD was diagnosed in 3 women who were under general anesthesia, in 7 women under neuraxial anesthesia and 2 under the combined group (25, 30 and 25 % relative to the total number of patients in the groups, respectively). The average rSO value was below the initial level in all groups: below by 6 % in the general anesthesia group, by 15 % in the neuraxial group, and by 10 % in the combined group. However, the differences were statistically insignificant (p >0.05). The study found no relationship between anesthetic techniques and POCD.
USING DIFFERENT DURAPLASTY VARIANTS IN THE TREATMENT OF PATIENTS WITH CHIARI MALFORMATION TYPE I
Kakhkharov R.A., Flegontov A.N., Mokhov N.V.
Стр. 56 — 61
The emergence of modern neuroimaging techniques has allowed for effective identification of patients with Chiari malformation. It is now possible to create a more accurate picture of this anomaly. Different surgical treatments can now be developed but this has led to standardization issues and lack of uniform recommendations for treatment of patients with Chiari malformation. A study conducted by the authors found that surgery involving the opening of the dura mater and subsequent plastic reconstruction by autoplastic graft was the optimal surgery option (with respect to volume of surgical treatment of such patients).
TROPHIC CHANGES IN THE SKELETAL MUSCLES OF RATS AFTER THERAPY WITH SILDENAFIL AND CEREBROLYSIN IN THE LOWER LIMB ISCHEMIA MODEL
Belous A.S., Biryukova Yu.K., Zatolokina M.A., Lavrinenko K.I., Loyko E.A., Mai G.S., Shevelev A.B., Trubnikova E.V.
Стр. 62 — 66
Formany patients with lower limb ischemia, surgical treatment isnot beneficial. Wehave studied theefficacy of combination therapy with sildenafil (Viagra) by Pfizer, France, and cerebrolysin (Ever Neuro Pharma, Austria) for lower limb ischemia in the Wistar rat model. The animals were divided into 6 groups (20 rats each): intact animals; sham-operated animals; rats with ischemia and no treatment administered (controls); rats with ischemia who received a 28-day monotherapy with sildenafil (2.2 mg/kg orally); rats with ischemia who received a 28-day monotherapy with 0.005 ml cerebrolysin; rats with ischemia who received a combination therapy with 2.2. mg/kg sildenafil for 7 days and 0.005 ml i. m. cerebrolysin for 10 days. Microcirculation in shin muscles was evaluated on days 21 and 28 of the experiment. On the same days, rats were overdosed with anesthetics and sacrificed in tens. Then, histological sections of shin muscles were prepared. Regional blood flow was significantly higher (p